Methods and devices for fractional ablation of tissue

Abstract

Methods and devices for ablating portions of a tissue volume with electromagnetic radiation (EMR) to produce lattices of EMR-treated ablation islets in the tissue are disclosed, including lattices of micro-holes, micro-grooves, and other structures. Also, methods and devices for using the ablated islets are disclosed, including to deliver chromophores, filler, drugs and other substances to the tissue volume.

1 . A device for aligning a tissue surface during ablation of the tissue comprising:
 a source of electromagnetic radiation having at least one wavelength component suitable for ablating the tissue;   an optical system configured to form the electromagnetic radiation into at least one beam;   an alignment member having a surface configured to be placed against the tissue, the alignment member including an array of openings extending through the surface; and   wherein the openings are aligned with the at least one beam to allow the beam to be transmitted to tissue pressed against the surface of the alignment member during operation.   
   
   
       2 . The device of  claim 1 , wherein the openings have a diameter between approximately 5 micrometers and 2000 micrometers. 
   
   
       3 . The device of  claim 1 , wherein the openings have a diameter of less than approximately 100 micrometers. 
   
   
       4 . The device of  claim 1 , wherein the openings have a diameter greater than the focal width of the at least one beam. 
   
   
       5 . The device of  claim 4 , wherein the diameter slightly exceeds the focal width. 
   
   
       6 . The device of  claim 1 , wherein the openings have a diameter approximately equal to the focal width of the at least one beam. 
   
   
       7 . The device of  claim 1 , wherein the openings are approximately circular. 
   
   
       8 . The device of  claim 1 , wherein the openings are elongated. 
   
   
       9 . The device of  claim 1 , wherein the openings are groove-shaped. 
   
   
       10 . The device of  claim 1 , wherein the openings are regularly spaced. 
   
   
       11 . The device of  claim 1 , wherein the openings are arranged orthogonally. 
   
   
       12 . The device of  claim 1 , wherein the openings are arranged hexagonally. 
   
   
       13 . The device of  claim 1 , wherein the optical system forms multiple beams, each beam being aligned with a corresponding opening of the alignment member. 
   
   
       14 . The device of  claim 1 , wherein the optical system is configured to form one beam and is further configured to scan the beam through an array of beam positions, each beam position corresponding to a location of a opening in the alignment member. 
   
   
       15 . The device of  claim 1 , wherein the surface of the alignment member is aligned with the optical system such that a focal point of the at least one beam is located a predetermined distance from the surface during operation of the device. 
   
   
       16 . The device of  claim 15 , wherein the predetermined distance from the surface is approximately less than or equal to the confocal depth of the at least one beam. 
   
   
       17 . The device of  claim 15 , wherein the predetermined distance is approximately less than or equal to 1 millimeter. 
   
   
       18 . The device of  claim 15 , wherein the predetermined distance is approximately less than or equal to 0.3 millimeters. 
   
   
       19 . The device of  claim 1 , further comprising a negative pressure device configured to draw the tissue against the surface of the alignment member during operation. 
   
   
       20 . The device of  claim 1 , further comprising a positive pressure device configured to press the tissue against the surface of the alignment member during operation. 
   
   
       21 . The device of  claim 1 , wherein the alignment member is configured to be moved relative to the focal point of the at least one beam during operation of the device. 
   
   
       22 . The device of  claim 21 , wherein radiation source is configured to produce pulses of electromagnetic radiation and the alignment member is configured to be moved during a time between pulses of electromagnetic radiation. 
   
   
       23 . The device of  claim 21 , wherein radiation source is configured to produce electromagnetic radiation in a continuous wave and the alignment member is configured to be moved during a time that the electromagnetic radiation is being produced. 
   
   
       24 . A device for aligning a surface of a tissue to be ablated comprising:
 a source of electromagnetic radiation having at least one wavelength component suitable for ablating the tissue;   an optical system configured to form the electromagnetic radiation into at least one beam;   a sensor configured to determine a distance between the surface of the tissue and a reference point of the device;   a controller configured to receive signals from the sensor and control the operation of the device based on the signals, wherein the controller inhibits the transmission of the electromagnetic radiation when the distance exceeds a first threshold.   
   
   
       25 . The device of  claim 24 , wherein the controller inhibits the transmission of the electromagnetic radiation when the distance is less than a second threshold. 
   
   
       26 . The device of  claim 25 , further comprising an adjustment mechanism in communication with the controller, wherein the adjustment mechanism is configured to realign the device during operation to maintain the distance between the first and second thresholds. 
   
   
       27 . The device of  claim 24 , further comprising an adjustment mechanism in communication with the controller, wherein the adjustment mechanism is configured to align the device to establish the distance between the first and second thresholds. 
   
   
       28 . A device for aligning a skin tissue surface during ablation of the tissue comprising:
 a source of electromagnetic radiation having at least one wavelength component suitable for ablating the tissue;   an optical system configured to form the electromagnetic radiation into at least one beam, the optical system having an output; and   first and second skin contacting members adjacent the output of the optical system, the first skin contacting member movable relative to the second skin contacting member;   wherein the first and second skin contacting members are configured to be in sufficient contact with the surface of the skin tissue during operation to stretch the skin surface when the first skin contacting member is moved relative to the second skin contacting member.   
   
   
       29 . The device of  claim 28 , wherein the first and second skin contacting member are configured to stretch the skin surface to an approximately uniform distance from the output of the optical system. 
   
   
       30 . The device of  claim 28 , wherein a focal point of the at least one beam is located at approximately a predetermined depth below the surface of the skin tissue during operation. 
   
   
       31 . A device for aligning a skin tissue surface during ablation of the tissue comprising:
 a source of electromagnetic radiation having at least one wavelength component suitable for ablating the tissue;   an optical system configured to form the electromagnetic radiation into at least one beam, the optical system having an output; and   a skin contacting member adjacent the output of the optical system;   a pressure source adjacent the skin contacting member;   wherein the pressure source is configured to mechanically manipulate the skin tissue during operation such that the surface of the skin tissue is located at a predetermined distance from the output.   
   
   
       32 . The device of  claim 31 , wherein the pressure source is a negative pressure source configured to pull the skin across the skin contacting member and thereby stretch the surface of the skin tissue. 
   
   
       33 . The device of  claim 31 , wherein the pressure source is a positive pressure source configured to push the skin over the skin contacting member and thereby force the surface of the skin tissue against the output. 
   
   
       34 . The device of  claim 33 , wherein the output is an array of lenses. 
   
   
       35 . The device of  claim 33 , wherein the output is a mask. 
   
   
       36 . The device of  claim 33 , wherein the output is an alignment member having an array of openings. 
   
   
       37 . A device for aligning a tissue surface during ablation of the tissue comprising:
 a source of electromagnetic radiation having at least one wavelength component suitable for ablating the tissue;   an array of optical lenses configured to transmit the electromagnetic radiation, the array having an exterior surface configured to be pressed against the tissue during operation, each lens of the array configured to form a beam of electromagnetic radiation to ablate the tissue; and   wherein the focal point of the beam is configured to be a selected distance from the exterior surface of the array.   
   
   
       38 . A device for aligning a tissue surface during ablation of the tissue comprising:
 a source of electromagnetic radiation having at least one wavelength component suitable for ablating the tissue;   an optical system configured to form the electromagnetic radiation into at least one beam;   an array of optical elements configured to transmit the electromagnetic radiation, the array having an exterior surface configured to be placed against the tissue during operation, each element of the array configured to correspond to positions of the at least one beam to allow the beam to be transmitted to tissue placed against the surface of the array during operation.   
   
   
       39 . A method for ablating soft tissue comprising:
 aligning the surface of the tissue to an approximately uniform distance from a reference point; and   ablating a plurality of portions of the tissue with at least one beam of electromagnetic radiation.   
   
   
       40 . The method of  claim 39 , wherein the surface is aligned along a focal plane of an optical system. 
   
   
       41 . The method of  claim 40 , wherein the step of aligning includes curving the surface of the tissue to match the curve of the focal plane. 
   
   
       42 . The method of  claim 40 , wherein the step of aligning includes flattening the surface of the tissue to match the curve of the focal plane. 
   
   
       43 . The method of  claim 39 , wherein the distance is approximately less than or equal to the confocal depth of the beam. 
   
   
       44 . The method of  claim 39 , wherein the distance is approximately less than or equal to the 1 millimeters. 
   
   
       45 . The method of  claim 39 , wherein the distance is approximately less than or equal to the 0.3 millimeters. 
   
   
       46 . The method of  claim 39 , wherein the distance is a first distance and further comprising altering the distance from the first distance to a second distance. 
   
   
       47 . The method of  claim 46 , wherein the step of altering the distance occurs during the step of ablating. 
   
   
       48 . The method of  claim 46 , wherein step of altering the distance further comprises altering the location of the focal point of the at least on beam of electromagnetic radiation relative to the surface of the tissue. 
   
   
       49 . The method of  claim 48 , wherein the step of ablating further comprises ablating by applying pulses of electromagnetic radiation, and wherein the location of the focal point is altered between pulses. 
   
   
       50 . The method of  claim 48 , wherein the step of ablating further comprises ablating by applying a continuous wave of electromagnetic radiation, and wherein the location of the focal point is altered when the continuous wave of electromagnetic radiation is being applied. 
   
   
       51 . The method of  claim 39 , wherein the step of ablating further comprises ablating by applying pulses of electromagnetic radiation. 
   
   
       52 . The method of  claim 39 , wherein the step of ablating further comprises ablating by applying a continuous wave of electromagnetic radiation.